Hand eczema in The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis (TOACS): prevalence, incidence and risk factors from adolescence to adulthood

Background Several studies have evaluated the incidence and prevalence of hand eczema in unselected adults. However, no studies have followed unselected adolescents from primary school into adult life to evaluate the course and risk factors for hand eczema. Objectives To estimate the incidence of hand eczema from adolescence to adulthood and the prevalence of hand eczema in young adults, together with risk factors for hand eczema. Methods A cohort of 1501 unselected eighth-grade schoolchildren (mean age 14 years) was established in 1995. In 2010, 1206 young adults from the cohort were asked to complete a questionnaire and participate in a clinical examination, including patch testing. Results The incidence of hand eczema was 8.8 per 1000 person-years. The 1-year-period prevalence of hand eczema in the young adults was 14.3% (127 of 891) and the point prevalence 7.1% (63 of 891), with significantly higher prevalence in females. At the clinical examination 6.4% (30 of 469) had hand eczema. Factors in childhood of importance for adult hand eczema were atopic dermatitis and hand eczema. Wet work in adulthood was a risk factor, as was taking care of small children at home. Interestingly, hand eczema among unselected young adults was associated with sick leave/pension/rehabilitation, indicating possible severe social consequences. Only 39.0% of patients participated in the clinical examination, while 75.0% answered the questionnaire. Conclusions A high incidence and prevalence of hand eczema were found in 28-30-year-old adults, and were highly associated with childhood hand eczema and atopic dermatitis, along with wet work and taking care of small children in adulthood. There was no association with smoking, education level or nickel allergy in childhood.